5 research outputs found
Musculoskeletal manifestations in polymyalgia rheumatica and temporal arteritis
OBJECTIVE—To evaluate the incidence and characteristics of musculoskeletal manifestations in polymyalgia rheumatica (PMR) and temporal arteritis (TA).
METHODS—The records of 163 cases of PMR or TA diagnosed over a 15 year period in one area of Spain were reviewed for the presence and type of musculoskeletal manifestations.
RESULTS—Of 163 patients, 90 had isolated PMR and 73 had TA. Eighteen of the 90 patients (20%) with isolated PMR developed distal peripheral arthritis either at diagnosis or during the course of the disease. When it occurred, synovitis was mild, monoarticular or pauci-articular, asymmetrical, transient, and not destructive. Other distal manifestations observed in these patients were carpal tunnel syndrome and distal extremity swelling with pitting oedema. In all cases these manifestations occurred in conjunction with active PMR. As expected, PMR was the most frequent musculoskeletal manifestation in patients with TA, occurring in 56% of cases. On the contrary, only 11% of patients with TA developed peripheral arthritis. An important finding was that peripheral arthritis in these patients appears to be linked only temporally to the presence of simultaneous PMR and is not observed in its absence. Distal extremity swelling or defined polyarthritis were not observed.
CONCLUSION—The spectrum of distal musculoskeletal manifestations of PMR in our series is similar to that reported in other populations. By contrast, distal musculoskeletal symptoms are uncommon in TA. The almost complete absence of distal musculoskeletal manifestations in patients with pure TA suggests different mechanisms of disease in PMR and TA, supporting the view of two separate conditions or one common disease in which host susceptibility influences the clinical expression.

Role of technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis: a comparative study
A comparative study of the parts played by technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis is presented. Nineteen patients were included in the study. All patients (11 men aged 19-70 years and eight women aged 18-72 years) had a history of back pain varying in duration from one to 15 weeks. A 99mTc diphosphonate bone scan was positive in 17 patients. The two patients with negative results had less than two weeks of back pain. The 67Ga citrate bone scan showed uptake in all patients
Isolated HLA-B27 cross reactive group (CREG) associated Achilles tendinitis.
SIR, We read with interest the article by Olivieri et al,
which describes a case of isolated HLA-B27 associated
Achilles tendinitis.' The authors suggest that Achilles
tendinitis may for a long time be the only feature of the
HLA-B27 associated disease process. We have recently
observed a patient with longstanding HLA-B7 associated
bilateral Achilles tendinitis without seronegative spondarthropathy..
Infectious arthritis in patients with rheumatoid arthritis.
Eleven cases of infectious arthritis occurring in patients with rheumatoid arthritis are reported. Staphylococcus aureus was the causative organism in eight patients. Streptococcus anginosus and Streptococcus agalactiae in one patient each, and Mycobacterium tuberculosis in two patients. The mean duration of symptoms before diagnosis was 16 days in patients with pyogenic arthritis. The diagnosis of joint infection caused by Mycobacterium tuberculosis was especially delayed (57 days). Four patients died; they were found to have a longer time to diagnosis and two of them had multiple joint infection. Although Staphylococcus aureus is the microorganism most often affecting patients with rheumatoid arthritis, infection caused by Mycobacterium tuberculosis must also be considered in such patients
Rheumatoid factor in patients with systemic lupus erythematosus.
SIR, In the report by Helin et al in the Annals' the authors
suggest that rheumatoid factor (RF) protects against
nephropathy in patients with systemic lupus erythematosus
(SLE).
We have reviewed our series of 78 patients with SLE
fulfilling the criteria of the above report for evaluating
nephropathy and assaying RF. The Waaler-Rose sensitised
sheep cell agglutination test was used to measure RF, with
titres equal or greater than 1/64 considered positive. Both
groups with and without renal disease were comparable for
age and sex. A renal biopsy was performed in 38 out of 40
patients with nephropathy..